Diabetes mellitus and obstructivesleep apnea syndrome in primary care
G. Coimbra dos Reis, V. Sacramento, V. Fonseca, C. Alves, I. Ferro, M. Guedes, P. Quintas, R. Marques, J. Cabrita, A. Pinto Saraiva (Barreiro, Lisbon, Portugal)
Source: Annual Congress 2012 - Metabolic and cardiovascular consequences of OSA II
Session: Metabolic and cardiovascular consequences of OSA II
Session type: Thematic Poster Session
Number: 3871
Disease area: Sleep and breathing disorders
Abstract Introduction: Obstructive Sleep Apnea Syndrome (OSAS) is a risk factor for insulin resistance and type 2 Diabetes Mellitus and its prevalence is higher on these. An adequate screening instrument for primary care units would be valuable. Objective: Evaluate Epworth Scale (ES) and Berlin Questionnaire (BQ), as screening instruments of diurnal hypersomnolence (DH) and increased OSAS risk in the diabetic population of a primary care unit. Methods: Observational, transversal, descriptive study, through the filling of a clinical characterization form and application of ES, BQ and cardiorespiratory polisomnography (CRP), on a randomized sample of the diabetic population of a primary care unit. Results: 117 patients, 48% male, mean age 65±8 years. The CRP revealed AHI≥5/h in 86 (73.5%) pts, 47 (40%) with AHI between 5-14, 20 (17%) with AHI 15-29 and 19 (16%) with ≥30 events/h. ES sensitivity‘s and specificity‘s was 20% and 91% for a cut-off≥10 and of 1.1 and 100% for a cut-off≥16. The NPV was 29.6% and 26.7% for those cut-offs. It couldn‘t identify DH on 72% of pts with AHI>15. The BQ classified 76 (65%) pts in high-risk group for OSAS. Roncopathy, diurnal somnolence and hypertension/obesity categories were positive on 72%, 17% and 83% respectively. For an AIH≥5/h, It‘s sensitivity and specificity was 71% and 52%, the PPV 80% and the NPV 39%. For an AHI≥15/h, the same statistical measures were 87, 46, 45 and 88%. For an AHI≥30/h, the results were 90, 40, 22 and 95%. Conclusion: ES showed low sensitivity and NPV as an HS screening test. The BQ had moderate sensitivity, low specificity and NPV, making it unreliable for application in this population. Reporting to a single unit these results may not be representative.
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G. Coimbra dos Reis, V. Sacramento, V. Fonseca, C. Alves, I. Ferro, M. Guedes, P. Quintas, R. Marques, J. Cabrita, A. Pinto Saraiva (Barreiro, Lisbon, Portugal). Diabetes mellitus and obstructivesleep apnea syndrome in primary care. Eur Respir J 2012; 40: Suppl. 56, 3871
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